Infertility Insurance – Limits, Mandates and ObamaCare – How to Pay For Infertility Treatment

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Infertility should be covered under your employer’s group insurance plan. It probably isn’t, so make sure to check your policy details. It is considered an optional treatment by insurance companies, just like breast reduction surgery or liposuction. It’s a serious problem if you feel the anxiety, fear, and mental weight of feeling pregnant month after month.

Infertility insurance – It’s the Law In 15 States

Before you panic, make sure to check whether your state has a mandated infertility treatment. Infertility treatment is covered by insurance in 15 states. Here is the complete list: California (New York), Texas, Massachusetts; Illinois, Ohio. Connecticut, Georgia. Hawaii. Arkansas. Montana. New Mexico. West Virginia. Rhode Island.

If you are in one of these states, make sure to check the coverage limits as they can vary widely – some very generous, some extremely limited. Advanced treatments like IVF or egg donation may not be covered. Even if your state requires liberal coverage, your small employer may exclude your group health plan from the law. You may also be exempted from the definition of infertility – check the law.

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Coverage not mandated in other states

You are dependent on your employer’s generosity for infertility coverage in the 35 states that do not have such laws. Only about one-fourth of plans cover infertility treatment. These plans may limit the types or extent of treatment, dollar limits or drug limits. Even if you have coverage, your out-of pocket costs are likely to be high.

New Federal Health Care Law, ObamaCare

The President Obama’s Health Care Initiative has been widely praised as a major improvement and a comprehensive overhaul that will provide expanded coverage and fairness for all. It might, but it won’t provide complete infertility coverage. Consider:

You won’t get help if you don’t need it now or next year. While some benefits are available now, the vast majority regarding insurance coverage will not be implemented until 2013.

– The new law’s more than 2,000 pages do not specifically address coverage for infertility treatment. Nor does it mandate coverage. We won’t be able to know if there is coverage.

What to Do

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Realize that you cannot deal with the future. These steps will help you if the cost of infertility treatment is too much for you and your partner.

Get an accurate estimate of the cost of your full treatment.

To determine the exact cost of your insurance, carefully review each plan.

Consider switching to a plan that offers better fertility coverage if one of your partners’ plans is less generous.

If you are offered the chance to work for an employer with generous insurance benefits, consider switching jobs.

Consider moving to a state that offers better coverage.

If none of these options are available, you may have to pay from your own resources for infertility treatment. These are some possible sources of funding once you have established the cost.

Your fertility clinic might offer payment plans or guarantees that will limit your costs to a certain extent. Before agreeing to these plans, make sure you carefully review them.

You can use your flexible-spending account to cover health expenses for infertility treatment.

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You can withdraw money from your 401K account but you should be aware of the potential tax consequences.

You may be eligible for a home equity loan if you’ve lived in your home for at least a few years.

Your parents (eager grandparents in the future) might be able to help.